Exploring the Effects of Literacy Instruction for Children With Cerebral Palsy: A Systematic Review

Abstract

Purpose: Some children with cerebral palsy (CP) have difficulty acquiring conventional reading and writing skills. This systematic review explores the different types of literacy instruction and their effects on the reading and writing skills of children with CP. Method: Relevant studies published between 2000 and 2020 were identified using electronic databases and terms related to CP and literacy. Data on participant characteristics, instruction characteristics, and instruction outcomes were extracted. A standardized measure of effect size was used to quantify reported treatment effects. Results: The systematic search identified 2,970 potentially relevant studies, of which 24 met inclusion criteria. These studies included 66 children with CP aged 5–18 years. One of the included studies utilized a group research design, whereas the remaining used single-subject designs. Studies investigated literacy instruction methods designed to teach phonics, sight-word recognition, reading fluency, reading comprehension, spelling, or written expression skills, or multicomponent instruction (instruction methods encompassing three or more of these skills). Most instruction methods were associated with gains in reading and writing skills with medium to large effects; however, our analysis of methodological rigor suggests that these findings need to be interpreted with caution. Conclusions: We propose that literacy instruction utilizing evidence-based principles can be effective for children with CP, provided instruction is accessible and allows children to demonstrate and receive feedback on their skills; however, further research is greatly needed. Clinical implications and priorities for future research are discussed. Supplemental Material: https://doi.org/10.23641/asha.21357558